New strategies for the total synthesis of a variety of medicinally important alkaloids are presented. Target structures include the Amaryllidaceae alkaloids lycorine, pseudolycorine, and lycorenine (p 10); the indole alkaloids apparicine and vallesamine (p 13); the Aspidosperma alkaloids quebrachamine, aspidospermine, vincadifformine, and vindoline (p 13); reserpine (p 18); the quinazoline alkaloid vasicoline (p 19); the pyrrolobenzodiazepine alkaloids anthramycin and tomaymycin (p 21); AT-125 (p 23); sparteine (p 24); emetine (p 26); indicine N-oxide (p 27); slaframine (p 31); azaphenalene alkaloids (p 32); the Securinega alkaloids (p 35); the lycopodium alkaloids lycodine and lycopodine (p 36) and the Erythrina alkaloids (p 40). Emphasis is placed on efficiency of skeletal construction. In most cases more than one approach is presented. The potential efficiency of most of these syntheses should allow for facile analog work. Several of the target molecules have demonstrated utility as anticancer agents. Others have found use in the CNS area (especially antihypertensives). Emetine is an established drug in the treatment of amoebic dysentery.